Segre Julia A
Genetics and Molecular Biology Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland 20892-4442, USA.
J Clin Invest. 2006 May;116(5):1150-8. doi: 10.1172/JCI28521.
Skin is at the interface between the complex physiology of the body and the external, often hostile, environment, and the semipermeable epidermal barrier prevents both the escape of moisture and the entry of infectious or toxic substances. Newborns with rare congenital barrier defects underscore the skin's essential role in a terrestrial environment and demonstrate the compensatory responses evoked ex utero to reestablish a barrier. Common inflammatory skin disorders such as atopic dermatitis and psoriasis exhibit decreased barrier function, and recent studies suggest that the complex response of epidermal cells to barrier disruption may aggravate, maintain, or even initiate such conditions. Either aiding barrier reestablishment or dampening the epidermal stress response may improve the treatment of these disorders. This Review discusses the molecular regulation of the epidermal barrier as well as causes and potential treatments for defects of barrier formation and proposes that medical management of barrier disruption may positively affect the course of common skin disorders.
皮肤处于人体复杂生理机能与外部（通常充满敌意的）环境之间的界面，而半透性的表皮屏障既能防止水分流失，又能阻止传染性或有毒物质进入。患有罕见先天性屏障缺陷的新生儿凸显了皮肤在陆地环境中的重要作用，并展示了出生后为重新建立屏障而引发的代偿反应。常见的炎症性皮肤病，如特应性皮炎和银屑病，其屏障功能会降低，最近的研究表明，表皮细胞对屏障破坏的复杂反应可能会加重、维持甚至引发这些病症。协助屏障重建或减轻表皮应激反应可能会改善这些疾病的治疗效果。本综述讨论了表皮屏障的分子调控以及屏障形成缺陷的原因和潜在治疗方法，并提出对屏障破坏的医学管理可能会对常见皮肤病的病程产生积极影响。
